As the infections are rapidly rising again, the old ghost image of full ICs is also threatening. If its up to Armand Girbes, intensivist at the Amsterdam UMC, we can only solve this problem by choosing more actively who we treat in the ICU and who does not, he tells Nieuwsuur. Other hospitals also see time for action.
RIVM reported 5,223 new infections today. Despite this, it is quieter in the ICs than in previous peak periods: 450 people were still in the ICU in 2020, now 164 are now in the ICU.
The question is how long it stays that way. Not only can more infections lead to more hospitalizations, but many hospitals are now dealing with a lot of staff failures.
“We see that capacity has decreased due to a lot of healthcare workers being ill,” Girbes tells Nieuwsuur. “Those are things that play our part.”
Health damage from deferred care
The so-called catch-up care, of interventions that had to wait due to corona and are now handled, is also pressing on the already thinned out workforce. “Theres a lot of talk about that catch-up care, but it doesnt end up so terrible.”
meantime, many non-covid patients do have complaints and problems they need to get rid of.
Girbes looks at a recent RIVM report showing how much health damage has occurred in non-covid patients. “Perhaps the damage in this category of patients is greater than the damage we have prevented in covid patients.”
And thats why, according to Girbes, we should start talking about a maximum number of IC beds in the Netherlands for covid beds. “We need to see how were going to distribute capacity fairly.”
Girbes believes that it should be taken into account how meaningful an ICtreatment per patient is or is not. “Youre going to look at what the patients chances of survival are, and how that relates to another category of patients,” says Girbes. “What nobody wants to talk about is that if you keep talking about corona, that means for those other patients.”
“Conversation we should have”
Other hospitals are not as secure as Girbes yet, but are open to talking about this. Peter van der Voort, head of department Intensive Care at the UMCG, calls it “an opportunity that should also be discussed”.
Iwan van der Horst, intensivist at Maastricht UMC, is happy to have talks about keeping the ICU functioning. “The discussion has not been explicitly held in our home, but we do talk about making difficult choices,” he tells Nieuwsuur. According to him, it would be helpful if the government would think about this. “No choice is the choice is not to choose and see how it goes.”
But what if you arrive at the hospital with severe respiratory distress due to covid and there is no place left? “There are a lot of treatment methods for people who are short of breath, who dont immediately lead to ICU recording,” says Girbes. According to him, per patient should be looked at when that IC recording is or is not really necessary.
“In the end, we all die,” says Girbes. “Its also time for us to realize that there are limits to what we can do.”